Department of Genetics, 300 Pasteur Drive, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Clinical Excellence Research Center, Stanford University School of Medicine, 365 Lasuen St, Stanford, CA, 94305, USA.
J Psychiatr Res. 2021 Jul;139:185-192. doi: 10.1016/j.jpsychires.2021.05.013. Epub 2021 May 7.
To compare the prevalence of cognitive symptoms and their functional impact by age group accounting for depression and number of other health conditions.
We analyzed data from the 2011 Behavioral Risk Factor Surveillance System, a population-based, cross-sectional telephone survey of US adults. Twenty-one US states asked participants (n = 131, 273) about cognitive symptoms (worsening confusion or memory loss in the past year) and their functional impact (interference with activities and need for assistance). We analyzed the association between age, depression history and cognitive symptoms and their functional impact using logistic regression and adjusted for demographic characteristics and other health condition count.
There was a significant interaction between age and depression (p < 0.0001). In adults reporting depression, the adjusted odds of cognitive symptoms in younger age groups (<75 years) were comparable or greater to those in the oldest age group (≥75 years) with a peak in the middle age (45-54 years) group (OR 1.9 (95% Confidence Interval: 1.4-2.5). In adults without depression, adults <75 years had a significantly lower adjusted odds of cognitive symptoms compared to the oldest age group with the exception of the middle-aged group where the difference was not statistically significant. Over half of adults under age 65 with depression reported that cognitive symptoms interfered with life activities compared to 35.7% of adults ≥65 years.
Cognitive symptoms are not universally higher in older adults; middle-aged adults are also particularly vulnerable. Given the adverse functional impact associated with cognitive symptoms in younger adults, clinicians should assess cognitive symptoms and their functional impact in adults of all ages and consider treatments that impact both cognition and functional domains.
比较按年龄组划分的认知症状的流行率及其功能影响，同时考虑抑郁和其他健康状况的数量。
我们分析了来自 2011 年行为风险因素监测系统的数据，该系统是一项针对美国成年人的基于人群的横断面电话调查。21 个州询问了参与者（n=131273）有关认知症状（过去一年记忆力或认知能力下降）及其功能影响（对活动的干扰和对帮助的需求）的问题。我们使用逻辑回归分析了年龄、抑郁史与认知症状及其功能影响之间的关联，并调整了人口统计学特征和其他健康状况的数量。
年龄与抑郁之间存在显著的交互作用（p<0.0001）。在报告有抑郁的成年人中，年龄较小组（<75 岁）的认知症状调整后优势比（OR）与年龄最大组（≥75 岁）相当或更高，其中中年（45-54 岁）组的峰值最高（OR 1.9（95%置信区间：1.4-2.5）。在没有抑郁的成年人中，年龄<75 岁的成年人的认知症状调整后优势比明显低于年龄最大组，除了中年组差异不具有统计学意义。与≥65 岁的成年人相比，超过一半有抑郁的年龄<65 岁的成年人报告认知症状干扰了生活活动，而≥65 岁的成年人中这一比例为 35.7%。
认知症状并非普遍在老年人中更高；中年人也特别容易受到影响。鉴于认知症状在年轻成年人中与不良的功能影响相关，临床医生应在所有年龄段的成年人中评估认知症状及其功能影响，并考虑影响认知和功能领域的治疗方法。
